目的：研究视网膜分支静脉阻塞继发黄斑水肿( macular edema secondary to branch retinal vein occlusion，BRVO-ME)抗血管内皮生长因子（vascular endothelial growth factor，VEGF）治疗后复发的相关因素。 方法：选取2021-2到2022-06在山东第二医科大学附属医院眼科中心就诊的BRVO-ME患者32例(32眼)，采取3+PRN的抗VEGF治疗方案，随访时间6个月。连续3次抗VEGF治疗后，据随访期间OCT的黄斑中心凹厚度(central macular thickness，CMT)变化，分为无复发组和复发组，应用悬浮液相检测法检测房水中多种细胞因子含量，比较两组间一般资料、CMT及细胞因子含量的变化，分析其与BRVO-ME抗VEGF治疗后复发的相关性。 结果：19只眼黄斑水肿消退(无复发组)，13只眼黄斑水肿复发或未消退(复发组)。与基线值相比，无复发组和复发组CMT在术后1天、术后1月及术后6个月均有所改善，差异有统计学意义(P<0.05)。与无复发组相比，复发组在基线、术后1天的CMT值更大，差异有统计学意义(P<0.05)。复发组房水基线VEGF、单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)含量均显著高于无复发组，差异有统计学意义(P<0.05)。Spearman相关性分析显示基线CMT与IL-1β，IL-5，IL-12，MCP-1及IP-10呈中度正相关(P<0.05)。多因素逻辑回归分析显示基线CMT、基线MCP-1含量是黄斑水肿复发的危险因素，差异有统计学意义(OR>1,P<0.05)。 结论：基线CMT和房水MCP-1水平是BRVO-ME患者抗VEGF治疗后复发的相关因素，基线CMT较高和房水基线MCP-1表达水平高的患者行抗VEGF治疗后更容易复发。

AIM: To investigate the risk factors associated with the recurrence of macular edema secondary to branch retinal vein occlusion (BRVO-ME) after anti-vascular endothelial growth factor (anti-VEGF) therapy. METHODS: A total of 32 patients (32 eyes) with BRVO-ME who were treated at the Ophthalmology Center of the Affiliated hospital of Shandong Second Medical University from February 2021 to June 2022 were selected. They were treated with a 3+ pro re nata (PRN) anti-VEGF regimen and followed up for 6 months. Following three consecutive anti-VEGF injections, patients were categorized into a non-recurrence group(19 eyes) and a recurrence group(13 eyes) based on central macular thickness (CMT) measured by OCT during follow-up. Aqueous humor levels of various cytokines levels were quantified using suspension assay method. Demographic characteristics, CMT, and cytokine levels were compared between the two groups, and their correlations with the recurrence of BRVO-ME after anti-VEGF treatment were analyzed. RESULTS: At 6 months post-treatment, macular edema resolved in 19 eyes (no recurrence group), while 13 eyes showrd persistent or recurrent edema ( recurrence group). Compared to baseline, the CMT significantly improved in both groups at 1 day, 1 month,and 6 months post-treatment( all P<0.05). However, the recurrence group exhibited significantly higher baseline and 1 day after surgery CMT values than the non-recurrence group(P<0.05). The aqueous humor levels of VEGF and monocyte chemoattractant protein-1(MCP-1) at baseline were significantly higher in the recurrence group than the non-recurrence group(P<0.05). Spearman correlation analysis revealed positive associations between baseline CMT and IL-1β，IL-5，IL-12，MCP-1 and IP-10 levels(P<0.05). Multivariable logistic regression analysis identified baseline CMT and MCP-1 levels as independent risk factors for BRVO-ME recurrence (OR>1,P<0.05). CONCLUSION: Elevated baseline CMT and aqueous humor MCP-1 levels were identified as independent risk factors for BRVO-ME recurrence after anti-VEGF therapy. Patients exhibiting higher baseline CMT and MCP-1 levels demonstrated significantly increased susceptibility to recurrence.

山东省医药卫生科技项目（保健项目）(NO.2023BJ000045); 2024年潍坊市青年医学人才托举工程